A 71-year-old woman presents with a 4-week history of dyspepsia and abdominal pain that she describes as gnawing. She states that for years she has had occasional heartburn, but she cannot recall having abdominal pain. She states that she also has arthritis and has taken Motrin every day for the past 2 years. For her stomach pain she has been taking Tums extra strength a couple of times a day. She states that the pain began soon after visiting her sister, who is a nurse at a mission in Nicaragua. Chief Complaint: “My stomach hurts and wakes me up from my sleep. I find myself belching after meals and I feel bloated.” Objective: Blood pressure (BP) 118/70 mm Hg, heart rate (HR) 90 beats/min, respiratory rate 18 breaths/min, BMI 29.

1. How will you use this information to prepare for today’s visit?

2. What additional subjective data are you seeking?

3. What additional objective data will you be assessing for?

4. What are the differential diagnoses that you are considering?

5. What laboratory tests will help you rule out some of the differential diagnoses?

6. What is your treatment and specific information on the prescription you will give to this patient?

7. What are the potential complications from the treatment ordered?

8. What additional specific laboratory tests will you consider ordering?

9. What additional patient teaching may be needed?

10. What type of specialist will you be consulting for this patient?